‘Hospitalist’ an important part of care

For little more than a decade, the “hospitalist” has been an integral part of how physicians and hospitals deliver health care. Specializing in the management of hospitalized patients, the hospital becomes their office; a 24/7 working environment to care for patients at all hours. The hospitalist takes over for a primary care physician, (PCP) or specialist when it comes time to admit a patient. At discharge, the care of the patient is returned to the admitting physician with recommended follow-up tests, treatments and after care instruction. For your average PCP or specialist, this means fewer — or zero — visits to the hospital at the beginning or end of their office hours for rounds. Phone communication between an office-based physician, the patient and the hospitalist, however, is essential to help maintain continuity and quality of care. Helping make these transitions from PCP or specialist to hospitalist as smooth as possible for the patient and caregiver is an area of great focus for hospital administrators. To be successful, a well-managed hospitalist program requires the support of the outlying PCPs and specialists.
Usually working on flexible, yet intense shifts of eight to 12 hours, the hospitalist completes his or her shift and hands the patient’s care to their fellow hospitalist to support round-the-clock, continuum of care.
Hospitalists are highly skilled at in-patient medical care and bedside teaching; they are available “in-house” throughout the day and night to counsel patients and family members, provide test results in a timely manner and/or change the course of treatment at a moments notice. Typically, they are Intensivists and Internal Medicine physicians, many of whom also possess specialty area certifications. It seems logical that the intensivist would make a great hospitalist. Their ability to care for the sickest patients and their life-saving interventions make them a natural choice for the role.
A general internist brings to the role a wealth of information and perhaps a greater perspective of caring for patients over a broader spectrum of illness than their intensivist colleague. Many hospitalists can care for a range of patient types at any given moment, from someone who just had back surgery, to someone who has been admitted with pneumonia or other illness or medical condition. Managing patients on a general floor is not the same as managing patients in an ICU. Internists may be better suited for the traditional medical and surgical hospital units and intensivists may be better for an intensive care unit type of environment.
Perhaps the best part about the hospitalist role is their ability and desire to collaborate and make decisions with the nursing staff. This type of attention provides the continuum of care needed to help sick people become well, getting them back to their regular, daily lives as quickly as possible. For the hospital, this focused attention means that patients’ lengths of stay are reduced, thus, opening beds for new patients to occupy.
According to Physician’s News Digest, words like “efficient,” “streamlined” and “cost effective” support medicine’s latest physician group. Their style of care is fast paced, their work ethic intensely focused, and they can shave a day off an average hospital stay in a single shift. Because of their office location right in the hospital, many hospitalists are active on committees that support the hospital’s administration and program development. They have an intimate working knowledge of the hospital where they work, making them more collaborative and resourceful in their role.
As with any profession there are pros and cons. Being a hospitalist is far from glamorous, especially depending on the number of patients needing care at any given time. Cold and flu season is especially impacted at most hospitals, where a patient’s cold or flu can worsen and require their being admitted to the hospital. Having the ability to work flexible schedules, and not having overhead concerns while trying to manage and operate an office are some of the “perks” of being a hospitalist. Another upside to being a hospitalist is that they are typically not on call after their shift has ended.
The hospitalist is one component of a successful health care delivery system for the present time and well into the future. Ask your physician how they would plan to treat you if hospitalized, and chances are that they will describe this type of physician partnership.


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